摘要
目的探讨类风湿关节炎(RA)患者的营养状况与临床症状体征的关系。方法选取RA患者123例,按类风湿关节炎患者病情评价(DAS28评分)分为活动组61例(DAS28>3.2)和低疾病活动组62例(DAS28≤3.2),按相应性别年龄特征选取同期住院诊断为颈椎病患者60例作为对照组,检测三组的血红蛋白(HGB)、白蛋白(ALB)、前白蛋白(PA)、视黄醇结合蛋白(RBP)、高密度脂蛋白(HDL)、总胆固醇(TC)、铁(Fe)、锌(Zn)等营养指标及球蛋白(GLO)、免疫球蛋白G(Ig G)、免疫球蛋白A(Ig A)、免疫球蛋白M(Ig M)等免疫指标,并进行组间比较及相关性分析。结果三组HGB、ALB、PA、TC、HDL、Fe、Zn、RBP比较差异有统计学意义(P<0.01),活动组、低疾病活动组的HGB、ALB、PA、Fe、Zn、RBP显著低于对照组(P<0.05或0.01),活动组的HGB、ALB、PA、TC、HDL、Fe、Zn显著低于低疾病活动组(P<0.05或0.01)。三组GLO、Ig G、Ig A、Ig M比较差异有统计学意义(P<0.01),活动组、低疾病活动组的GLO、Ig G、Ig A显著高于对照组(P<0.05或0.01),活动组的Ig M显著高于对照组(P<0.05或0.01),活动组的GLO、Ig A显著高于低疾病活动组(P<0.05)。HGB、ALB、PA、HDL、RBP、Fe与DAS28、GLO、Ig G、Ig A呈负相关(P<0.05或0.01),Zn与GLO、Ig A呈负相关(P<0.05或0.01)。结论 RA患者存在蛋白质、血脂、微量元素代谢紊乱,与摄入不足、免疫功能紊乱及疾病活动相关。
Objective To investigate relationship between nutritional status and clinical symptoms of patients with pa- tients with rheumatoid arthritis(RA) .Methods According to Disease Activity Score -28 (DAS 28) of RA patients, 123 ca- ses of RA were divided into activity group (DAS28〉3.2) and low disease activity group (DAS28 ≤ 3.2), with 61 cases in the activity group and 62 cases in the low disease activity group.60 cases with corresponding age and gender characteristics -- who were admitted to hospital in the same period and diagnosed with cervical spondylosis -- were selected as control group. Then, nutritive indexes including hemoglobin ( HGB ) , albumin ( ALB ) , prealbumin ( PA ) , retinal binding protein ( RBP ) , high-density lipoprotein ( HDL), total cholesterol ( TC ), iron ( Fe), zinc ( Zn ), etc. were tested. Meanwhile, immunity indexes like globulin( GLO), immunoglobulin G(IgG) ,immunoglobulin A (IgA) and immunoglobulin M (IgM) were also tested be- tween groups.All of the above-mentioned indexes were compared and correlation analysis was conducted between groups.Re- stilts Differences of the HGB, ALB, PA, TC, HDL, Fe, Zn and RBP of the three groups were statistically significant ( P〈 0. 01 ). HGB, ALB, PA, Fe, Zn and RBP of the activity group and low disease activity group were significantly lower than those of the control group (P〈0.05 or 〈0.01 ). And HGB, ALB, PA, TC, HDL, Fe and Zn of the activity group were significantly lower than those of the low disease activity group (P〈0.05 or 〈0.01 ). Differences of GLO, IgG, IgA and IgM of the three groups were statistically significant( P〈0.01 ).GLO, IgG and IgA of the activity group and low disease activity group were sig- nificantly higher than those of the control group (P〈0.05 or ~0.01 ).And IgM of the activity group was significantly higher than that of the control group(P〈0.05 or 〈0.01 ).GLO and IgA of the activity group were significantly higher than those of the low disease activity group (P〈 0.05). There was negative correlation between HGB, ALB, PA, HDL, RBP, Fe and DAS28, GLO, IgG, IgA ( P〈 0.05 or 0.01 ). In addition, Zn was negatively correlated with GLO and IgA ( P〈 0.05 or 0.01 ). Conclusion Metabolic disturbance of protein, blood lipid and microelement are found in RA patients, which may be associated with in- adequate intake, immune dysfunction and disease activity.
出处
《右江医学》
2015年第2期137-142,共6页
Chinese Youjiang Medical Journal
基金
2012-2013年右江民族医学院科研项目立项课题(合同编号:yy2013ky004)